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Suicidal behaviour in mood disorders--who, when, and why?
Summary
Suicide risk is high in mood disorders, particularly during depressive or mixed episodes. Factors like substance use, personality disorders, hopelessness, and adverse events increase this risk, necessitating better understanding for prevention.
Area of Science:
- Psychiatry
- Psychology
- Public Health
Background:
- Mood disorders are a significant risk factor for suicide, accounting for a substantial proportion of suicide deaths.
- Understanding the specific risk factors associated with mood disorders is crucial for developing effective suicide prevention strategies.
Purpose of the Study:
- To review the literature on risk factors for suicide completion and attempts in individuals with depressive and bipolar disorders.
- To identify key factors that contribute to suicidal behavior in mood disorder populations.
Main Methods:
- A comprehensive literature review was conducted.
- The review focused on studies examining risk factors for completed and attempted suicide in patients diagnosed with depressive disorders and bipolar disorders (BDs).
Main Results:
- The lifetime risk of completed suicide in mood disorder patients is estimated between 5-6%, with bipolar disorder potentially having a higher risk than major depressive disorder.
- Suicidal acts predominantly occur during major depressive episodes (MDEs) or mixed illness episodes, with a 20-40 fold increase in suicide attempt incidence during these periods.
- Comorbid substance use, cluster B personality disorders, hopelessness, impulsive-aggressive traits, childhood adversity, recent adverse life events, and poor social support are significant risk factors for suicidal behavior.
Conclusions:
- Suicidal behavior in mood disorders often happens during MDEs or mixed episodes, frequently with comorbid conditions.
- While illness factors play a role, they do not fully explain suicidal behavior.
- A complex interplay of illness factors, difficulties with impulse control, early life adversities, and current life situations contributes to the process of suicidal thinking, planning, and actions.